In addition to performing a preventive medicine visit on a 15-month-old established patient, the physician replaced a gastrostomy tube that was pulled out by the patient during the encounter. The replacement of the tube required about 20 minutes. How should these services be reported?

Report Current Procedural Terminology (CPT®) code 99392 (preventive medicine visit, age 1 through 4 years, established patient) linked to International Classification of Diseases, Ninth Revision, Clinical Modification (ICD-9-CM) code V20.2 (routine infant health check). Also report CPT code 43760 (change of gastrostomy tube, percutaneous, without imaging or endoscopic guidance) linked to ICD-9-CM code V55.1 (adjustment to gastrostomy). Modifier 25 (significant, separately identifiable evaluation and management [E/M] service) should be appended to code 99392. Any other services that have a CPT code that were performed and documented should also be reported (eg, vision screening, hearing screening).

We are not getting paid for CPT code 31720 when we...

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